Women's Heath in the Field

Some things are different for women in the field, and we have some special health concerns.  This is text from a file that someone at McMurdo gave me AFTER my first deployment to the McMurdo Dry Valleys.  I thought I would post a slightly edited version here.  This is not my text, and I don't know where it comes from for sure.  It is information that should be widely shared among women who may be heading into the Antarctic wilds!

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Women’s Health and Comfort Concerns for Antarctic Field Deployment

URINATION:

Pee Bottles are required in the Dry Valleys unless you are in a camp facility with another sanitary setup.  For trips away from camp, even for a few hours, take your pee-bottle.  A pee bottle is simply a water bottle appropriately labeled that still has a good cap. You can get one from the BFC.  Transporting your pee to an appropriate disposal site is your responsibility – as is keeping the bottle from freezing!  Aside from Dry Valley use, a pee bottle is a great way to handle night-time urges without a trek to the latrine, as well as a convenience in colder weather peeing.  Peeing in the bottle is pretty easy – it is best to place the bottle against your body to make a good seal rather than holding it away and trying to hit the hole from a distance.

Pee Rags - this is a bandanna or rag scrap that serves a variety of purposes.  It is good to wipe with and then store in an outer pocket.  On a non-snowy day, you can tie it to something to let it air and it will sublimate dry.  You can carry it in an outer pocket for a few days too.  In the cold, dry climate, you’ll be surprised how relatively clean it can stay.  When opportunity permits, rinse and dry for reuse.  If you do choose to use toilet paper, be sure to take it back to a proper disposal site.

Pee funnels - Grantees, a limited number of pee funnels are available at the BFC if your PI didn’t already order them.  For non-grantees, check with the BFC. These can be ordered in the “other world” through boating and aviation supply catalogues, among other places.  Pee funnels are great inventions to allow convenient urination without undressing.  You can use a funnel/bottle combination, or have an extension hose on the end of the funnel to make sure that the liquid discharge clears your clothing.  If you have never used one of these, it is a great idea to do several practice runs in town to get the hang of it.  Secrets for success are proper positioning of the funnel and insuring that you get a good seal between it and your body. There are a variety of models available.  [Note from Dawn: I like the Freshette because the tube can extend through many layers of clothing. See tips on using a pee funnel at the end of this post.]

Dehydration to avoid peeing is a bad, bad idea!  Drinking enough water is key to avoiding hypothermia, keeping up energy levels in the cold, properly digesting food, normal bowel movements – and drinking enough water means that you are going to need to pee several times during the day and more than likely get up in the night as well.  It is better to learn comfortable and effective ways to deal with peeing that seeking to avoid it.

MENSTRUATION

Women may experience changes in their menstrual cycle while in Antarctica.  Physical and emotional demands that are different than normal may trigger hormonal changes causing menstrual periods to decrease in length, flow, and/or temporarily cease.  Timing of cycles can often be effected as well.  Even if you don’t expect your period during your field time, it is worth bringing what you would need for a cycle and a few extra.  A good rule of thumb for planning amounts --- take what you would normally need, add enough for an additional cycle, and chuck in a few extras.

It is a good practice to wash hands or use alcohol-based hand sanitizer before inserting tampons, if feasible, to decrease the risk of vaginal infection.   Some women like to alternate the use of pads and tampons, a practice recommended by some physicians to avoid toxic shock syndrome.  There can be a temptation to leave a tampon in for longer than normal due to the difficulty involved in changing them, and this should also be avoided to prevent TSS and possible vaginal infection.

Used tampons and pads should be bagged and carried out of the field and disposed of properly as Dormitory Biological Waste. Field camps should have such a container available, and women out on day or multi-day excursions can take along several ziploc bags to use for this purpose.  One approach that works well is to carry a small plastic ziploc of unused supplies, a second ziploc with a small brown sack inside to collect used supplies.  Both of those carried in a small stuff sack make a convenient and private field package.  Some women also carry baby or hand wipes in that package to take advantage of a hygiene opportunity.

Lastly, if you are taking ibuprofen for cramps, make sure you are drinking enough water with it.  Extended use of ibuprofen with inadequate hydration is a kidney stressor, so many physicians recommend drinking extra water with each dose.

VAGINAL INFECTIONS

Vaginal infections usually result from an alteration in the pH of the vagina that allows bacterial growth that normally wouldn’t happen.  Things that contribute to that change include:  1) lower immune resistance due to increased physical and emotional stress; 2) a diet high in sugar; 3) birth control pills - especially if you are just starting or stopping their use; 4) taking antibiotics; 5) diabetes or a pre-diabetic condition; 6) poor hygiene.

Signs and symptoms of a vaginal infection are itching and/or soreness in the vaginal.  Usually there is excessive and/or malodorous discharge.  There may or may not be pain with urination.  Any of the above signs could indicate a vaginal infection.  Treatment can be with antibiotics (which further contribute to a pH imbalance);clean, warm water douches or an OTC preparation; or appropriate medicine for a yeast infection (Monistat or Diflucin). 

Suggestions to reduce risk of infection:

·       Wipe from the front to the back to limit introduction of bacteria into the vaginal area.  Wash the vaginal area with water and/or a mild soap daily if possible, or as often as is feasible.  If water isn't available, daily use of baby wipes can be very helpful.

·       Wear cotton underwear and change it daily, preferably before sleeping.  Nylon retains moisture which helps bacteria to grow.  Washing underwear when able also helps, but even just airing and drying helps.  [Dawn's comment - special "quick dry" travel underwear such as that made by Patagonia is MUCH better than cotton.]

·       During menstruation, change tampons and pads frequently, washing hands or using alcohol-based hand cleaner prior to insertion of tampon if feasible. 

·       If you are prone to vaginal infections, consider decreasing your sugar intake.  Substitute tea for cocoa, water for fruit drinks, and nuts for candy bars.

SEXUAL ACTIVITY

Just a thought about doing it in the field.  Neither of you are as clean as you are in the town environment where you shower daily with chlorinated water.  There are lots more bacteria present, and introduction of foreign bacteria, especially if there is some chafing, can contribute to vaginal and urinary tract infections in women.  Methods to reduce risk of infection include washing prior to sex, use of condoms, washing hands, etc.  

Pee Funnel Tips

(also from an unknown source at McMurdo)

Why Using the Funnel is a Great Thing

1. It frees you up to pee in harsh weather conditions with out compromising your warmth.
2. If you are on a rope team, in a harness, and cannot untie, but need to urinate, the funnel provides easy relief.
3. The pee flag is often exposed to not only the elements, but to everyone passing by. The funnel provides you with privacy, you won’t have to drop trough with everyone in camp walking past.  [Note from Dawn:  A pee flag was a spot on sea ice that is designated for peeing. One can pee on the ice without harmful environmental impacts, but it is really unpleasant to have pee everywhere.  Pee flags are now decommissioned, I believe, but workers on the ice still designate a spot to go.]
4. The most important point is hydration. It is imperative for good health to hydrate and the funnel makes it easier for you to be willing to do so.

Using your Pee Funnel

1. Practice. Practice in the shower with out any clothes. Practice at the toilette in easy access clothes, such as long underwear or PJ’s. Then practice in your ECW [extreme cold weather gear]. Practice going in a pee bottle, including on your knees, as if in a tent.
2. If you are wearing your bibs, unzip the fly, maneuver your underclothes down a bit, and maybe unzip the side zip. Slip the funnel in through the fly with one hand (LFT) and have the other hand (RT) inside your bibs to maneuver the funnel into place and hold it there. Meanwhile your LFT hand is ensuring that the hose is not bent. After practicing a bit, maneuvering clothes down and unzipping the side zip is not necessary.
3. Peeing standing up is difficult at first. The key is to relax your muscles. It helps to bend your knees; and while learning, it is very helpful to bend your knees and lean them against the toilet.
4. In the beginning or for extended deep field use, it is a good idea to use panty liners. Always with Wings work well. They act like a diaper and catch most mistakes before they hit your clothes. Because you don’t wipe with TP [although you can if you dispose of it properly, or you can use a pee rag], the liner also helps maintain good hygiene.

Accidents to Watch Out For

1. Your pee funnel comes in two parts, a pink funnel and a clear hose that extends out and seals tightly in the pink funnel. If the hose is not fully extended or is bent, it will leak and you will pee your pants. There are three common ways for this to happen:
1. Ice has formed between the funnel and the hose. The connection appears secure but when the warm urine melts the ice, there’s trouble. To prevent this, you not only have to pull the hose out until the stopper ring on the hose is tight up against the funnel but you also may want to give it a few twists side to side to free the ice.
2. You’re in a hurry and you don’t ensure that the hose is fully extended. This is a mistake that you are likely to make once you feel comfortable with the funnel and have had many success stories. This common mistake will dampen your spirits.
3. To avoid a bent hose you need to ensure that all your clothes are tucked underneath the hard pink plastic part of the funnel as opposed to letting your clothes apply pressure to the clear hose. If, say, the elastic band on your long underwear is pressing on the clear hose, it will bend it up and pour urine out between the bottom of the pink funnel and the clear hose. Thereby soaking your clothing. Depending on the type of bibs you have, you may need to lengthen the shoulder straps in order to have enough space to not apply pressure to the clear hose.

2. The biggest disaster is when a complete seal is not kept between you and your funnel. There are two ways in which this can happen:
1. You are lightly holding the funnel up between your legs, but not with enough pressure. The urine will pour over the sides, front and/or back. This is a simple mistake to solve. Press the funnel hard against you, jam it, wiggle it, and know that it is secure.
2. The next common sealing problem would be if you tuck a little piece of your shirt, underwear, etc., into the funnel by a mistake. What happens here is sneaky. You think you are having a successful pee. You let loose, relax and go. When you are finished and remove the funnel, you realize that you are wet, that the wetness is spreading and that you will soon be cold. You may think that this is unlikely. Think again! With all of those layers on, you have to ensure that not even the tiniest scrap is tucked in.

Cleaning your Funnel

1. Wash with warm water and soap. You can also occasionally run a water and bleach solution through the funnel. If none of that is an option, you can use a wet wipe and give it the once over.
2. Wash the stuff sack in the laundry. Shake the funnel after each use before putting away; you’ll be surprised how clean your stuff sack actually stays.
3. Menstruation: You can still use the funnel. Everything flushes through and the funnel doesn’t need much additional cleaning.